Can diabetes and blood sugar change over time?

Blood glucose levels increase after eating and return to baseline within a few hours. The amount by which blood glucose rises after eating is largely determined by meal composition, prior physical activity, and the time of day because glucose tolerance (i.e., how well the body resists spikes in blood glucose after eating) peaks in the morning and declines in the afternoon and evening.^[1] Glucose tolerance also tends to decline with age.^[2]

Lifestyle changes can lead to a remission of type 2 diabetes. Following specific diets (e.g., low-carb, vegan, fasting) probably isn’t that important, so long as the chosen eating plan facilitates a sustained, moderate calorie deficit that results in weight loss (sometimes as little as 5%–10% of original body weight) and a reduction in intra-organ fat.^[3][4][5] In fact, given that weight loss and maintenance is so challenging, people who are seeking to improve their type 2 diabetes with weight loss should simply focus on dietary patterns that are realistic, sustainable, and as mentally and emotionally healthy as possible. Even if weight loss isn’t attainable, physical activity alone can improve some key measures of type 2 diabetes, such as HbA1c.^[6] That said, these benefits are still most pronounced when there’s a simultaneous increase in physical activity and decrease in body weight.^[7]